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Case Reports
. 2020 Jan 3:17:100586.
doi: 10.1016/j.ajoc.2020.100586. eCollection 2020 Mar.

Schwartz-Matsuo syndrome: An important cause of secondary glaucoma

Tyler Etheridge  1 , Jennifer C Larson  1 , T Michael Nork  1 , Anna C Momont  1
Affiliations
Case Reports

Schwartz-Matsuo syndrome: An important cause of secondary glaucoma

Tyler Etheridge et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: We report a case of Schwartz-Matsuo syndrome that highlights the pathophysiology, diagnostic challenges, and management considerations of this rare disease.

Observations: 31-year-old man with a history of left eye cataract presented with left eye photophobia and elevated intraocular pressure (IOP) of 64 mm Hg. Visual acuity 20/40. Open angles with an increased pigment of trabecular meshwork by gonioscopy, 2 + anterior chamber (AC) cell, superior retinal detachment, and 0.6 cup-to-disc ratio. Electron microscopy of AC fluid demonstrated outer segments of photoreceptors. IOP was lowered with oral and topical ophthalmic antihypertensives. Retinal detachment was treated with pars plana vitrectomy with endolaser, gas tamponade, and AC paracentesis. Follow-up VA 20/20 with normal IOP.

Conclusions and importance: Schwartz-Matsuo syndrome is characterized by elevated IOP with marked fluctuations, open angles, aqueous cells, and retinal detachment. Diagnosis is supported by electron microscopy of AC fluid with outer segments of photoreceptors. Treatment includes retinal detachment repair and antihypertensive therapy.

Keywords: Open-angle glaucoma; Retinal detachment; Schwartz-Matsuo syndrome.

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Conflict of interest statement

The following authors have no financial disclosures: T.E., J.C.L., T.M.N., A.C.M.

Figures

Fig. 1
Fig. 1
Left Eye Fundus Photography. A superior retinal detachment of the left eye and advanced cupping of the left optic nerve compared to the right eye.
Fig. 2
Fig. 2
Left Eye Optical Coherence Tomography (OCT). Subretinal fluid confirming the presence of retinal detachment with adjacent loss of outer segments of photoreceptors.
Fig. 3
Fig. 3
Electron Microscopy of Anterior Chamber Fluid. Pigmented epitheloid cells containing stacked membranous lamellar structures consistent with outer segments of photoreceptors.
See this image and copyright information in PMC

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